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General NPI Number Information
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NPI Number | 1689727935
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Entity Type | Individual
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Provider Name | RIAZ RAYEK DDS
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4210 FAIRFAX CORNER WEST AVE SUITE 220
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City | FAIRFAX
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State | VA
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Zip | 22030-8619
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Country | US
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Telephone | 703-222-3245
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Fax |
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Provider Business Mailing Address
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Address Line | 25639 ELK LICK RD
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City | SOUTH RIDING
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State | VA
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Zip | 20152-4277
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Country | US
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Telephone | 703-327-8650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401410397
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License Number State | VA
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